2026 Guide to Long-Term Acne Treatment: From Isotretinoin to 1726 nm Sebaceous-Gland Lasers

The following rating is not an official ranking of a certain medical guideline, but a comprehensive comparison based on long-term data, clinical evidence, treatment convenience and recurrence up to 2026.

The three options most worth comparing are:

Isotretinoin, AviClear, Accure.

Isotretinoin has been used for decades, but in terms of its mechanism of action, it is still the most comprehensive acne medication currently available.

It is not simply an antibacterial drug.

Isotretinoin acts on several key pathways involved in acne formation at the same time, including:

• Significantly reduce sebum secretion;
• Shrink sebaceous glands;
• Improve abnormal keratinization of hair follicles;
• Reduce the formation of acne;
• Reduce the survival conditions of acne-related microorganisms in the hair follicle environment;
• Suppresses inflammation.

Therefore, the biggest difference between isotretinoin and ordinary antibiotics is:

The effects of the medication may continue after you stop taking it.

The American Academy of Dermatology makes it clear that isotretinoin treatment can often lead to prolonged clearance, that is, long-term acne clearance, which can even be permanent for some patients. The AAD currently also strongly recommends isotretinoin for patients with severe acne, prone to scarring, significant psychological burden, or patients who have failed conventional oral and topical treatments.

Latest large-scale recurrence data

A very valuable large-scale study was published in "JAMA Dermatology" in 2025.

The study analyzed:

19,907 acne patients who received a complete course of isotretinoin.

Average follow-up:

24.9 months.

Results:

• 77.5% did not experience acne recurrence requiring systemic drug treatment;
• 22.5% experienced recurrence;
• Only 8.2% ultimately received another course of isotretinoin.

The study also found that higher cumulative doses were associated with lower relapse rates, while simply pursuing very high daily doses did not show the same obvious advantage after reaching the conventional cumulative dose.

If the question is simply:

"How long will it last after stopping treatment?"

Isotretinoin still has the strongest and most mature long-term evidence.

Advantages

• The evidence for long-term efficacy is the most mature;
• Very effective for moderate to severe, nodular and cystic acne;
• Reduce whiteheads, blackheads and inflammatory acne at the same time;
• After a complete course of treatment, many patients do not require systemic treatment for many years;
• The cost is usually much lower than laser.

Disadvantages

The most common ones are:

• Severely dry lips;
• Dry skin;
• Dry nasal cavity;
• Dry eyes;
• Blood lipids may be elevated;
• Liver function may change.

The most important question is:

Isotretinoin has a clear risk of serious teratogenicity and should never be used during pregnancy.

This is a prescription medication, not a cosmetic product to buy online and dose without medical supervision.

If there is any technology in the past 40 years that is most likely to truly challenge the status of isotretinoin in the field of "long-term acne removal", then the one that deserves most attention right now is:

1726nm laser.

There is a fundamental difference between it and ordinary acne laser.

Traditional lasers may mainly:

• Anti-inflammatory;
• Sterilization;
• Improve blood vessels;
• Heated leather;
• Improve acne marks.

The design goal of 1726nm is:

Heats sebaceous glands directly.

Sebum has high absorption of wavelengths near 1726nm, so it can cause thermal damage to sebaceous glands through selective photothermal action, while at the same time protecting the epidermis as much as possible through the cooling system. Histological and experimental studies have proven that 1726nm can produce selective thermal effects on sebaceous glands.

This is very similar to the logic of laser hair removal.

Laser hair removal:

The hair absorbs the laser → the hair follicles are thermally damaged → long-term hair loss.

1726nm acne removal:

Sebaceous glands absorb laser → sebaceous glands are affected by heat → sebum secretion is reduced for a long time → acne formation conditions are changed.

That's why it deserves special attention.

AviClear is a 1726nm laser device developed by Cutera.

Japanese version uses:

1726nm InP diode laser.

Official specifications include:

• Wavelength: 1726nm;
• Maximum output: 90W;
• Maximum energy density: 30J/cm²;
• Contact cooling;
• Cooling temperature: 0~5℃.

Japanese PMDA data shows that AviClear has been obtained:

Manufacturing and sales approval number 30700BZX00107000

Approved for therapeutic use:

Moderate to most severe acne vulgaris.

In other words, AviClear is no longer a simple "beauty salon machine" in Japan, but a officially approved high-risk management medical device.

This is a very big change in the field of acne treatment in Japan since 2025.

At present, the most worthwhile thing to watch is not the manufacturer’s promotion, but the long-term follow-up.

Prospective study of 104 people

104 patients with moderate to severe acne received:

Three times of 1726nm treatment.

The interval between treatments is approximately:

2 to 5 weeks.

Proportion of patients with inflammatory skin lesions reduced by ≥50% after treatment:

A very interesting point is:

After the treatment, the effect does not disappear gradually, but continues to improve.

The one-year follow-up results will be published in the "Journal of the American Academy of Dermatology" in 2026.

This is where 1726nm is very different from ordinary beauty lasers.

In July 2026, "Journal of the American Academy of Dermatology" published another real-world two-year follow-up study related to AviClear.

The results show:

After 24 months of treatment, 75% of patients achieved skin clearing or near-clearing status.

This is a set of real-world evidence that the long-term effects of 1726nm technology are very important at present.

In addition, an earlier small study in 17 patients observed an approximately 97% reduction in inflammatory lesions from baseline at 24 months of follow-up. But this number must be interpreted with caution because:

• The sample is only 17 people;
• Part of a smaller open-label study;
• Some related research involves the participation of equipment manufacturers.

Therefore it cannot be simply promoted as:

"AviClear is 97% effective in two years."

A more scientific statement should be:

Many studies have shown that the improvement after 1726nm treatment can last for at least 1 to 2 years. Some patients continue to improve after the end of treatment, but the effect after 5 and 10 years is still unclear.

We can’t say that yet.

The reason is very simple:

AviClear FDA approval does not take long. At present, high-quality long-term studies can only mainly track:

About 1 to 2 years.

So scientifically we can only say:

Has long-term effects.

Cannot say:

Forever.

But if follow-up in the next 5 or even 10 years still shows a very low recurrence rate, then it does have the potential to become one of the treatments closest to "physical long-term acne removal".

Currently the most common standard treatment courses:

3 times.

Usual intervals:

About a month.

Japanese clinical institutions usually introduce it about once every 4 to 6 weeks, 3 times in total, about 30 minutes each time.

And don’t expect to be completely free of acne the next day after the first time.

The typical process is:

First time → Limited improvement

↓

The 2nd to 3rd time → Oil production and inflammation began to be significantly reduced

↓

3 months after treatment → further improvement

↓

6 to 12 months → Many patients reach their best condition

So it is very different from many projects in the field of medical beauty that “see immediate results on the same day”.

For the convenience of comparison, the overseas prices in this article are uniformly converted into RMB based on the reference exchange rate on August 19, 2026; the actual cost will vary depending on the exchange rate, treatment area and institutional charges.

In 2026, more and more medical institutions will appear in Japan.

Public prices vary widely.

For example, Aoba Clinic currently announces:

About 250 shots for the whole face: about RMB 2,100 per shot.

Another Japanese dermatology company publishes prices:

Full face: approximately RMB 2,800 per session.

Therefore, the current more realistic full-face price in Japan can be understood as:

Single

About RMB 2,100~3,000

3 standard treatments

Approximately:

About RMB 6,400-8,900.

Different hospitals, number of irradiation shots and treatment areas will significantly affect the price.

Currently it generally belongs to:

Free diagnosis and treatment at your own expense.

This is a major advantage over PDT and some RF.

AviClear features an active skin cooling system.

Treatments in clinical studies usually do not require anesthesia, and there are no cases of treatment termination due to pain; Japanese institutions also describe that most patients mainly feel local heating, slight tingling, or a "pop" feeling.

Common situations include:

• Temporarily red;
• Heat feeling;
• Slight swelling;
• A small number of people suffer from short-term acne or inflammation fluctuations.

Appreciable downtime is usually not required.

However, Japan's PMDA equipment instructions also list some situations that require special attention, such as recent use of isotretinoin, photosensitivity drugs, anticoagulant drugs, and specific skin diseases. Therefore, it should be judged by a regular doctor instead of judging whether it can be done by yourself.

Its most valuable scenario isn't all people with a pimple or two.

It is particularly suitable for:

1. Moderate to severe inflammatory acne

Especially:

• Dozens of red pimples often break out;
• Oil secretion is very strong;
• As needed for many years;
• Relapse occurs when antibiotics are stopped.

2. People who do not want to take medicine for a long time

Especially very resistant:

• Long term antibiotics;
• Isotretinoin;
• Hormonal therapy.

3. People who are not suitable for isotretinoin

For example, people who are unable to undergo isotretinoin treatment due to medical reasons can discuss 1726nm with a dermatologist.

4. People who want to reduce the need to apply medication every day for a long time

The greatest value of 1726nm is:

Few treatments.

This is completely different from requiring long-term daily use of topical medications.

Another device that must be introduced is:

Accure Acne Laser.

It also uses:

1726nm.

The purpose is also to selectively heat the sebaceous glands.

But it uses a different set of control logic:

Real-time temperature monitoring + Treat-to-Temperature algorithm + forced air cooling.

In other words, the machine will monitor the skin surface temperature and dynamically adjust the output, hoping to heat the sebaceous glands to the target temperature while controlling epidermal damage. This system has been described in detail in related technical papers.

The U.S. FDA currently approves Accure for:

Long-term treatment of mild to severe inflammatory acne vulgaris.

The standard treatment course currently introduced by Accure officials is usually:

4 treatments

Interval:

About 1 month.

Official information says:

• The average acne reduction is about 70%;
• Up to about 90% of patients achieve at least 50% improvement at 6 months;
• Some subjects have been followed for more than 30 months.

However, compared with AviClear, there are still relatively few open, independent, long-term peer review data with a larger sample, so we should not say at this stage:

Accure must be better than AviClear.

A more accurate evaluation is:

Both machines use the same very promising biological target, but the large-sample long-term data currently disclosed by AviClear is more mature.

The technical advantages of Accure are mainly reflected in:

Real-time temperature feedback control.

Currently it is more common in the US market.

Approximate open market price:

Single

About RMB 6,100-9,500.

Complete treatment course

About RMB 17,000~27,100.

Different medical institutions vary greatly.

So from the price point of view:

AviClear and Accure are both relatively expensive acne treatments.

If you choose one of the two in 2026:

In Japan

In Japan, it deserves more priority:

AviClear.

It’s not because Accure is technically poor, but because:

• Japan has officially approved it;
• There are more and more hospitals;
• More transparent prices;
• More long-term clinical data;
• 3 treatments are more convenient.

Before the emergence of 1726nm, one of the technologies that really tried to change the sebaceous glands in the long term was:

Photodynamic Therapy,PDT.

The treatment process is generally:

Apply photosensitizers such as ALA/MAL to the skin

↓

Photosensitizer enters sebaceous glands and hair follicles

↓

Wait for a while

↓

Specific light source

↓

Generate photochemical reaction

↓

Destroy some sebaceous glands, reduce acne-related microorganisms and reduce inflammation.

PDT is therefore a legitimate treatment, not a gimmick.

It has a lot of medical research.

Systematic reviews in 2025 include:

82 studies, 4340 acne patients.

These include:

• 56 prospective studies;
• 25 randomized controlled trials.

Comprehensive results show that PDT can indeed improve acne, but different ALA concentrations, light sources, exposure times and protocols vary greatly. The average follow-up time of the study is only about 3 months, and the longest is about 13 months.

So its biggest disadvantage is not "ineffective".

Instead:

Standardization is insufficient, and the long-term evidence is not as good as isotretinoin and the latest 1726nm.

PDT can appear:

• Obviously burning;
• Pain;
• Redness and swelling;
• peeling;
• Scab;
• Photosensitive;
• Post-inflammatory pigmentation.

The 2025 systematic review of procedural acne treatment also pointed out that PDT has good efficacy in treating inflammatory acne, but pain and burning limit its tolerance.

With the emergence of 1726nm technology, the appeal of PDT is also declining.

For example, a medical institution in Japan that specializes in treating acne is now publicly available:

Full face PDT: approximately RMB 2,240 per session.

Cheeks:

About RMB 1,120 per trip.

If multiple treatments are required, the total cost can easily reach several thousand yuan or even more than 10,000 yuan.

Therefore, if the price is close to AviClear, it is more worthy of giving priority to the 1726nm solution.

There is also a very interesting idea.

Not with a laser.

Instead:

Use the needle directly close to the sebaceous gland, and then release RF high-frequency energy.

The more typical ones are:

AGNES Class I single pin RF.

The operation logic is roughly:

Find the hair follicles prone to recurring acne

↓

The needle enters near the hair follicle

↓

Release RF deep in sebaceous glands

↓

Thermal damage to sebaceous glands

↓

Reduces the ability of this hair follicle to produce large amounts of sebum in the future.

This is completely different from the often said "needle picking at the root of acne".

"Pick the root of acne with a needle" is just:

Dig out the corner pegs.

What AGNES is really trying to do is:

Thermal damage of sebaceous glands that produce large amounts of sebum.

So from a mechanism perspective, the latter has medical logic.

Yes.

A total of 63 patients completed a randomized controlled study.

The patient received 3 sebaceous gland-selective single-needle RF treatments. Compared with the control group of microneedle + acne removal, the improvement of inflammatory acne was significantly better at 12 weeks.

There has also been some recent, more extensive RF research.

A one-year follow-up of non-invasive monopolar RF in 2025 showed that improvements in inflammatory and non-inflammatory skin lesions and sebum levels were maintained in patients who completed 12 months of follow-up. However, only 11 people completed the one-year follow-up, so the scale of evidence is much smaller than that of isotretinoin or AviClear.

It has even appeared in 2026:

Low-dose Isotretinoin + Microneedle RF

The randomized prospective study comparing isotretinoin alone shows that "drugs to reduce overall sebum activity + RF to locally treat sebaceous glands" is becoming a new research direction.

The really meaningful scenario is not the dozens of pimples all over the face.

Instead:

Always grows in the same places over and over again.

For example:

• The chin is fixed in several positions;
• Alar of nose;
• Between the eyebrows;
• Hairline;
• The same pore repeatedly forms large inflammatory acne.

There is a certain logic in dealing with the sebaceous glands one by one in this case.

If there are 100 acne-prone hair follicles on the whole face, it would be very inefficient to treat each one with a needle.

At this time, 1726nm full-face scanning is obviously more reasonable.

Japan’s institutions vary greatly.

For example, a Tokyo cosmetic dermatology department currently discloses the price of AGNES:

Because it belongs to:

Sebaceous gland-by-gland treatment.

So it is especially suitable for small amounts of recurring acne.

Microneedle RF such as POTENZA and Morpheus8 can also be used:

• Heated leather;
• Improve inflammation;
• Reduce some sebum;
• Improve pores;
• Also improve acne scars.

So they are for:

Having acne + already having acne scars

This type of patient is valuable.

But if the purpose is simply:

“Don’t get acne again.”

Existing evidence still does not reach the level of 1726nm and isotretinoin.

The review of laser and energy equipment in 2026 also specifically pointed out: 1726nm is a new technology that is more in line with the biological mechanism of acne, while the current main advantages of segmented laser and RF platforms are still more reflected in acne scar remodeling.

Published Japanese prices for POTENZA treatment of active acne vary widely, from about RMB 2,100 to RMB 4,670 per full-face session.

These machines are not ineffective.

For example:

• 1450nm diode;
• 1064nm Nd:YAG;
• PDL;
• KTP;
• Some near-infrared lasers.

You can pass:

• Thermal effect;
• Reduce inflammation;
• Improve blood vessels;
• Indirectly affects sebaceous glands

To improve acne.

But the biggest problem is:

They are not precisely designed to target the sebaceous glands.

This is the significance of the emergence of 1726nm.

The latest 2026 review also believes that light and near-infrared lasers in the past can have a certain effect on acne, but lipid-selective 1726nm technology is the current development direction that is more in line with the logic of sebaceous gland targeting.

Therefore, if the hospital claims that the ordinary 1064nm laser has the same effect as AviClear, this statement is not reliable.

Blue light mainly uses porphyrins produced by acne-related bacteria to absorb specific light and cause photochemical reactions.

Red light is more inclined to:

Anti-inflammatory.

So blue light + red light:

It can have an auxiliary effect on mild to moderate red acne.

But it doesn't really permanently change the sebaceous glands.

The systematic review found that the overall sample size of blue light studies was small and of short duration, and many studies had a high risk of bias.

AAD also pointed out:

Blue light/red light is mainly suitable for inflammatory papules and is not fully effective on blackheads, whiteheads, cysts and nodules.

So:

LED is suitable for auxiliary control.

Not suitable for promotion as:

Long-term cure.

IPL can improve:

• Red acne;
• Inflammation;
• Red acne marks;
• Part of the sebum;
• Skin color.

But it is not a sebaceous gland selective device.

The AAD 2024 guidelines even believed that the existing evidence at that time was insufficient to establish routine acne treatment recommendations for laser, phototherapy, chemical peels and microneedling, and clearly gave a conditional objection to "broad spectrum light/IPL with adapalene 0.3%".

Note:

The systematic review of this guideline preceded the subsequent large amount of long-term 1726nm data.

So it cannot be simply understood as:

"AAD considers AviClear useless."

In fact, many of the one- and two-year long-term data of AviClear were only officially released in 2025-2026.

Because these things are mainly dealing with:

Problems that have developed.

For example:

Salicylic acid

Reduce the clogging of hair follicles.

A fruit acid

Promote keratin renewal.

HydraFacial

Remove oil and keratin plugs.

Comedone extraction

Take out the contents of the acne that has formed.

These treatments can result in visibly clearer skin in the short term.

But as long as:

Sebaceous glands continue to produce sebum + hair follicles continue to abnormally keratinize

New acne can form again.

So they fit:

Assistant in clearing acne.

Instead of:

Long-term changes in acne constitution.

After removing various marketing terms, we can find that there are only two logics that are truly effective in long-term acne removal.

Route 1: Change sebaceous glands

Representative:

• Isotretinoin;
• AviClear;
• Accure;
• AGNES/RF;
• PDT.

Route 2: Prevent pores from re-clogging for a long time

Representative:

• Adapalene;
• Retinoic Acid;
• Trifarotene;
• Long-term maintenance treatment such as BPO.

The first is:

Try to change the environment that produces acne.

The second one is:

As long as the physiological conditions that predispose you to acne still exist, suppress it for a long time.

AAD still strongly recommends topical tretinoin and BPO.

Situation 1: Severe cysts and acne, leaving scars

Preferred consideration:

Isotretinoin.

Reason:

• Decades of clinical experience;
• The most large-scale evidence;
• The strongest ability to treat severe acne;
• Long-term mitigation data are mature;
• The cost is significantly lower than high-end lasers.

Situation 2: Moderate to severe acne, but don’t want to take isotretinoin at all

Preferred research:

AviClear 1726nm.

Especially in Japan, it has become a very realistic choice after 2025.

Situation 3: Extremely oily and recurring red pimples

It’s worth comparing:

Isotretinoin vs AviClear.

This is truly the most meaningful set of choices out there.

Situation 4: There will always be only a few fixed pores with recurring acne

Consider:

AGNES and other sebaceous gland-targeting RFs.

In this case, there is no need to have expensive laser treatments on the entire face.

Situation 5: Acne is developing and there are already a lot of acne scars

Consider:

Control active acne first

Then:

Microneedle RF / Fractional Laser

Manage scars.

Don’t mistake acne pit devices for long-term acne control devices.

Situation 6: Only slight closure of the mouth and occasional pimples

There is absolutely no need to spend more than RMB 6,000 on AviClear from the beginning.

Usually:

Adapalene + BPO and other standard treatments

The price/performance ratio is much higher than that of high-tech equipment.

This is the most debatable issue in 2026.

If we look at medical evidence alone

Currently:

Isotretinoin wins.

If you read "No need for long-term medication + direct physical effect on sebaceous glands + few systemic side effects"

Then:

AviClear is very advantageous.

It is starting to emerge as a new technology that is truly capable of competing with isotretinoin as a long-term treatment route.

Because there is not enough time.

Isotretinoin has been used for decades.

1726nm commercial equipment is only a few years old.

Existing data can illustrate:

1 year is good.

2 years is also good.

But I don’t know yet:

How about 5 years?

How about 10 years?

Will the sebaceous glands partially recover?

Will the remaining sebaceous glands compensate?

Will acne break out again after hormonal changes?

Will it change again when you enter adulthood after adolescence treatment?

These issues still require long-term research.

In the past, people often simply understood acne as:

“Too many bacteria on your face.”

So various products are wildly promoted:

• Sterilization;
• Remove mites;
• Deep cleaning;
• Detox;
• Pick at the root of the acne.

Modern acne medicine has become increasingly clear:

Acne is a chronic inflammatory disease of the pilosebaceous unit.

So the most promising new technologies are increasingly concentrated in:

Control or alter sebaceous glands.

The 2026 Acne Laser Review also believes that energy devices are developing from traditional anti-inflammatory and antibacterial directions to targeting sebaceous gland biology, and 1726nm lipid-selective laser is one of the most important new directions.

This may also be the real main battlefield for acne treatment technology in the next ten years.

Be especially cautious when seeing the following promotions:

"Pull out the root of the acne and it will never grow again"

There is no such medical structure.

“One laser cures all acne permanently”

There is currently no long-term evidence to support this.

"Delete deep toxins"

There is no so-called pore toxin theory in acne medicine.

“Kill the mites and you will never get acne”

Acne vulgaris is not the same thing.

"Permanently shrink all pores"

Similarly unrealistic.

“Completely change your acne physique in three days”

Treatments that actually change the sebaceous glands usually take weeks to months to see final results.

If combined:

• Scientific evidence;
• Long-term effects;
• Recurrence rate;
• Security;
• Ease of operation;
• Price;

As of August 2026, long-term acne treatment programs can be roughly divided into three levels.

First echelon

1. Isotretinoin

The long-term evidence is the most mature.

Suitable for:

Severe, stubborn, scar-prone acne.

2. AviClear 1726nm

The new generation of physical acne removal technology that deserves the most attention at present.

Suitable for:

People who want to reduce long-term medication, have excessive oil, have moderate to severe inflammatory acne, and want long-term control.

Second echelon

3. Accure 1726nm

The technical logic is very good, but the current scale of public long-term evidence still needs to continue to accumulate.

4. Sebaceous gland targeting RF / AGNES

Especially suitable for recurring acne in fixed locations.

5. PDT

The scientific basis is sufficient, but the advantages of pain, recovery period and protocol standardization are being weakened by 1726nm.

The third echelon: auxiliary treatment

Includes:

• Nd:YAG;
• 1450nm diode;
• IPL;
• LED;
• Chemical peel;
• Comedone extraction;
• HydraFacial.

They are not completely ineffective.

Just:

They should not be promoted as "long-term acne cure" techniques.

As of 2026, the medical community is still far away from truly “permanently eliminating acne.”

But the direction of treatment is now much clearer.

Past:

Treat the pimple after you have it.

Now:

Target the sebaceous glands that help drive acne.

At present, the most mature long-term evidence is still:

Isotretinoin.

The new technologies that deserve the most attention are:

1726nm sebaceous gland selective laser.

Especially AviClear, which as of 2026 already has:

• Japan’s official medical device approval;
• Indications for moderate to severe acne;
• Prospective study of 104 people;
• One-year follow-up;
• Two-year real-world follow-up;
• Data across a range of skin tones;
• No need to take medicine every day;
• Usually only about 3 treatments are needed.

Therefore, if long-term follow-up in the next 5 to 10 years maintains the current results, a 1726 nm laser is likely to become the most important technological advancement in the history of acne treatment after isotretinoin.

But today, the most scientific statement should still be:

Isotretinoin remains the best-established treatment for long-term remission; 1726 nm sebaceous-gland lasers are the most promising non-drug option for lasting control.

What does not exist is a treatment that can guarantee everyone:

One treatment, followed by a lifetime without another breakout.